This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards.
"The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale

Thursday, 9 December 2010

Post from a disillusioned Nurse

I found this on allnurses and can understand everything this poor girl is saying. It is all true. Families and Patients behave this way because of their social conditioning about Nurses and because of unrealistic views they have as a result of media portrayals of Nurses, Doctors, and Hospitals. A hundred years ago sick and dying patients were cared for at home. Families understood first hand what illness and death actually look like. The sick and the terminal wasted away,developed sores and became delirious at home with their family members watching and doing everything possible. No Nurses or Doctors were around to blame it all on.

I recently read an account of the death of Willie Lincoln, a 12 year old boy in 1862. His father was the president of the United States. Willie contracted Typhoid fever and screamed in agony as his bowel perfed. This sickness and suffering went on for months. He was treated at home, in his parents bed. He wasted away to nothing and lost his mind through delirium. His family had front row seats to the reality of sickness and death. They had no Nurse around to blame it on. If they had a Nurse I doubt they would have started screaming at her because pharmacy delivered medication late or because the x ray department couldn't fit Willie in for an xray that day. They would have been grateful that those things existed. I doubt they would have accused her of Starving their son when he got past the point of being able to eat and digest food, a usual part of terminal illness. I think they would have been intelligent enough to realise that Nurses have no control over those things.

People today have a very sanitised view of it all thanks to TV. Therefore they cannot handle the realities of sickness and death. The reality is that terminal sickness and death looks like hell, even with the best of modern medicine. When they are confronted with this reality they go absolutely apeshit on the very people killing themselves to try and help. So very sad. They are going to embitter every Nurse we ever train and run them the hell away from the bedside. The following was written by a Nurse who has been in the profession for 5 years.

When I was in nursing school, I was so excited to get finished and get a job. I thought I would enjoy doing nursing tasks all day...meds, IVs, injections, dressing changes, catheters, assessments. I was so proud to tell people I was becoming a nurse. My job would be exciting all day long. I would be working hard and helping people. I would get respect...

But 5 years later, ha! What a joke! Don't get me wrong. I am grateful to have a job in this bad economy, but nursing sure turned out to be a disappointment. I never thought that I would be worked to death the way nurses are. I never thought I would be talked to like a dog the way I am by patients, their families, people from other departments, and some doctors. I never thought bosses would be so quick to stab you in the back and try to get you in trouble. I thought I would be a valued employee and appreciated for what I did because I am a nurse who truly has a heart, cares about my patients, likes to get along well with others, and work as a team.

Instead, as a nurse you are treated like a peon. You have a team of 15 patients and are running like a mad woman to take care of all of them properly while your manager sits on her butt looking for any one tiny thing you might miss (while not offering to lift a finger to help you). Families sit in the room watching you like a hawk assuming you are going to hurt their family member..... Griping because you have to turn people with skin issues or check for incontinence. Griping because you have to change an IV. The other day I had a family member sitting there watching me like a hawk as I had to change the patient's IV site. Mind you the patient was an obese lady with huge arms and had had to have deep lines in the past due to difficult access. She said to me very rudely, "You get ONE stick, then somebody else is gonna do it." Then proceeded to stand and watch me with her arms folded across her chest. Excuse me, since when does the family dictate my job? That really burnt me up. Fortunately I got her IV on the first stick, but I have to take crap like that from people or I would probably be written up by my manager. I never thought nursing would be like this. When I visited people in the hospital before I was a nurse I had respect for the medical staff and would never dream of talking to them the way I am talked to.

You are blamed for everything. Doctor comes in late today? Nurse is yelled at about it by family. Doctor changes a medicine and doesn't tell the family about it or the Nurse? Nurse is grilled about it. Lab wakes patient early for blood draw? Nurse is yelled at about it. Doc orders stat MRI at 5 pm on a Friday? Nurse is yelled at about it by Radiology. Assistant doesn't check patient for incontinence while nurse is trying to medicate a critically patient in the other room? Nurse is yelled at about it by family. Medicine is late from pharmacy? Nurse is yelled at about it. Dietary doesn't send up a food tray for a patient or send up what the patient ordered then refuses to communicate with the Nurse? Nurse is yelled at about it by patient and family. Family members interrupt you while you are trying to calculate a cardiac drips that the doctor ordered to stop your heart patient from dying to ask where mum's nightdress went. Then they throw a tantrum because your won't stop what you are doing to look for it. What the hell makes these people think that a Nurse with multiple patients can provide them with service? Are they all mad? We can do nothing right. It has really been disheartening. We go into nursing to help people and instead are treated like crap. I can honestly say that nursing is the job I have felt I have been the least respected in of all the jobs I have ever had. It has just been very disappointing. I WANT to like nursing because I spent all of this time getting trained and getting licensed but wow.

I detect an American twang from your poor girl which shows that these problems are common to us all. In the developed world anyway. In the third world I suspect that families take more responsibility for themselves.

Death is the last taboo. It is sanitised on TV and the awfulness of dying, so well described in the story of Willie Lincoln, is no longer experienced by the public. When their loved ones don't suddenly drop their head and die peacefully and instead go through death rattles or worse they really do sometimes think the staff are to blame. Perhaps we are useful foils at a time of real distress that they have difficulty handling.

It is interesting how relatives do expect to be waited on hand and foot when death is close. They hang around the beds of the dying like ghouls. Woe betide if they miss the moment of death. Not that it is a moment. They seem to have forgotten that their purpose in being there is to bring comfort to the dying and do what they can to help. Instead they stand and watch, afraid even to puff up the pillows. That's the job of the hospital.

Perhaps all this is our fault. Perhaps we should have leaflets for relatives on what to expect when somebody dies. Maybe we should explain that it is their duty to do what they can to make their loved one comfortable. We need to give them some responsibility and empower them to do some caring.

No doubt that these problems are global. I found when I worked in North America that the situation wasn't as tough as it is in the UK. Over here, everyone from the porters to the housekeepers to pharmacy and equipment library think that the Nurses work for them

I agree about education. We need to educate people about this stuff prior to becoming sick. Any Nurse who tries to be honest with people whilst they are traumatised is labelled mean and cruel etc. We need to get to people before they get sick.

I have been saying that for years. Characters on every soap opera that are admitted to hospital are always in a single side room – never a bay. This is of course to keep production costs down (they would have to pay extras to play other patients). Consequently characters are never moved from these side rooms to bays as they are in reality when their health greatly improves. The side rooms in soaps are always big enough to accommodate most of the entire family with still plenty of room too.

A very good post by Anonymous (9 Dec at 02:59) I agree with every part of it. And after such experiences the public then start to believe that euthanasia is a good idea as it would then bring on this instant death you mention and they (the relatives) would not have to sit through such an “ordeal”.

Notice that on telly they always show a dying patient looking beautiful with perfect makeup, clear breathing and they are always lucid and chatting until the very end.

They should show them with eyes lids open, eyes rolled back up into their heads mouth gaping open, rattling chest sounds and as yellow as the sun. Sunken cheeks and a god awful smell as well.

And that is after they had every drug and treatment that modern healthcare can provide.

There are also lots of Nurses at the nurses station on these shows...just waiting for someone to shout "Nurse" and then provide instant service. We all know that in real life patients shout for "Nurse" all the time and we are usually unable to stop what we are doing right and there and see to them at that moment without harming another.

Yes, you are right. Nurses are treated like absolute garbage. I would love to kick family members out of the room, tell the patient you are so obese, which is why you are here. I'd love to tell management that the reason they are in management is because they were treated badly as a staff nurse and are happy now that they can treat their own staff badly. There is no organization that supports or protects nurses. Doctors unload on nurses because they can't offend the patients. All other employees are enjoying the fact that if they make errors, are late with tests, food, etc... the nurse will be yelled at.

Anger again: Call Nurse lazy because she didn't wash your loved one properly whilst disregarding the fact that there are only enough staff to keep patients alive. And she worked a 14 hour shift without food or drink.

More Anger: Accuse every Nurse who is at the nurses station waiting for report, waiting for a call back or trying to get information etc of standing around gossiping, Just to feel better about yourself.

Last Stage is More denial: Make up stories about modern Nurse training pulling student Nurses off the wards and not ensuring compassionate Nurses. They will make up these stories because they cannot make sense of what they are really seeing.

It surprises me is the amount of abuse a nurse has had to take. As a consultant, I confronted a relative and banned them from speaking to my junior doctors because of 4 episodes of abuse, she could only speak to me for information. She was very polite to me. The same relative was even more abusive to nurses (very personal offensive remarks) but their seniors just said that the ward nurses should avoid antagonising her as it might escalate the situation. I don't understand why.

A Nurse friend of mine got punched by a relative because pharmacy took 5 hours to prepare and deliver the patient's discharge meds.

Management asked the Nurse what she did to deserve that kind of treatment.

And a lot of these family members are just plain nutters or simply just cannot deal with stress. If they think having a loved one very sick (been there myself) is tough they should try being the sole RN for 19 patients with all that entails.

By the way consultant I see your profession moaning a lot about Nurses leaving the bedside and going into desk/clipboard jobs? You lot accuse them of thinking they are above doing basic nursing.

Bullshit.

They just want to be away from the abuse. They don't mind doing basic nursing care. A desk/clipboard job means no abuse from nutcase relatives/doctors/path lab/radiology/housekeeping/and patients as well as really good hours and getting to see your babies open their presents on christmas.

On my first placement we had a gentlemen who was dying very slowly, and without any frigging mercy from the man in the sky. He had brain mets and the poor sod was hanging on for days and days. Then the rattle started. Now I have witnessed rattle before, but the smell from the excess buildup of phlegm combined with the fact that he had this rattle for days was just too much. It invaded the entire ward if I'm honest. It was really bad and not alot of the Nurses had witnessed a buildup and smell quite like it. We tried suction etc but eventually and on the last day we were just repositioning him and leaving him in peace, he had been through enough particually since he had been in this condition for days and was slowly drifting away. We drew the curtains around and the family sat with him for a few hours.

Then in the middle of the fricking dinner round, and 6pm drug round, I walk past the curtained off bed with 2 IV drips in my hand heading towards my mentor and get grabbed, by the arm, and dragged into the curtain. One of the relatives noticed we missed her father on the drug round. I explained to her that we are no longer giving her father any medicine and he is on a driver for pain killers and very comfortable. She then yanks my arm and at this point twisting the skin. I ask her polietly to let go and she goes on about how we don't care and the smell isn't to do with his lungs it's because we haven't washed him in days and the doctor didn't explain to them that he wasn't having medication anymore etc, and we were neglecting him. Oh and this was a relative who 10 minutes prior happily asked the Nurses for her fathers meal, then ate it herself saying her dad woulden't be needing it and complaining about the quality of food in the loudest voice possible behind the curtain as if it was her meal to have!

Now we had seen this patient every hour without fail, the family know this. We were changing his sheets and clothes and giving him a little wash and suctioning what we can and putting him in a nice comfy position. I explained all of this and the relative went on to say that we were neglecting her father in other ways because a nurse should be with them and her father at all times until he dies to ensure he is comfortable...

WTF! At this point I yank my arm away from her and explain I will page the doctor to come and explain things again. She was obviously scared though. Death like this is very scary, particually when all you watch on TV is something telling you otherwise. She didn't want to be alone behind this curtain even with her family there and I don't blame her but it's just one of the few examples of how I've witnessed realtives kicking off because it's not all rainbows and pots of gold when their loved one dies. It should be explained better, or at least portrayed more accuretly.

My mentor eventually came to my rescue and all of the relatives stormed out of the ward and kicked off outside the sisters office. For once our sister was on our side and backing us up but usually she likes her little peacefull serine ward and if that means the Nurses get taken up the ass then it will happen, but this time it was obviously the doctors fault for not coming to see the relatives. In the midst of all of this the relatives ended up being off the ward for THREE WHOLE HOURS. at 9pm when I'd finished my shift I sat down next to the patient to finish my notes and write some stuff up in my portfolio and he passed away there with me sat beside him. The relatives eventually turn up 10 minutes later with bags and bags of McDonalds and drinks laughing amongst themselves and complaining that it's too hot for them on the ward, find out he's died, and start kicking off that he died without them there and that we should have waited!! WE!!! Now not only are we neglegant we are in control of who dies and when. It was abhorrent.

Oh and I coulden't move my arm the next day. It was charming. I love my job.

In the middle of a drug round that was already very late,meal time and dealing with a patient who needed NIV I was sent an admission from AAU.

She was stable and fine. I don't even know why she was admitted to hospital really. I think the res home just couldnt handle her anymore.

She came onto the ward with her son. I dropped what I was doing to settle her in, show her the call bell, give her a quick assessment check on any new orders, meds that were going to be due soon etc etc. I spoke to her son and explained everything that was going on, gave him all the information I could regarding his mother's condition and what to expect.

Then I went back to my NIV patient who should never have been left.

About 5 minutes later and HCA stopped me. "Your new patients daughter is here and she demands that you come down there and tell her about what is happening with her mum". says the HCA

I told the HCA that I already told the son everything that there was to tell and that I wasn't going to leave my NIV patient again to talk to repeat myself.

The HCA relayed this to the daughter and politely asked her to hang on because I was busy and had already spoken to the son.

The next thing I knew all hell broke loose. The HCA came running out of the room. The daughter was screaming "get that fucking bitch over here NOW to talk to me about my mum, how dare she think that anything else is more important".

This is how these people are. They want things on their terms. And management doesn't get them under control. They almost encourage them to lash out at the Nurses.

It is a shame because if we could teach visitors how to behave we could have 24/7 visiting hours for them.

There should be really strict rules about relatives being on the ward full stop.

Not only do they cause enourmous amounts of stress to the patients, when they should be resting, they disturb other patients too.

Whats with all the long-lost relatives turning up too when granny smith has broken her hip? They haven't visited the poor cow for 3 years at her home yet they turn up, unannounced at 3pm on a busy ward demanding to see their loving grandmother.

Then if it's not that, friends and relatives ring at all hours, usually when the patient is in physio, or in the middle of seeing the consultant, demanding to know how they are and to speak with a doctor or in great lengths with whoever is unlucky enough to pick up the phone about their mother/friend/neighbours care.

When I did my trust induction our placement advisor suggested we should really stand up to relatives particually when they are badgering us and being bossy and uncooperative but it's hard when the words "I'm going to complain" usually follow this action even if you have a pin or not. You don't want to get into trouble, yet you don't want to constantly be disturbed.

When my first ward was closed because of the norovirus for a few weeks and only ONE relative could visit the most sickest patients in the evening for half hour in the evening after dinner etc it was amazing. The patients were more content (even the ones with norovirus), dinner time went alot more smoothly and the drug rounds went amazingly well. Yes we didn't have any admissions or discharges but all the beds were full with acute patients so we were busy anyway, but things just ran very well.

I just fucking hate relatives. Full stop. When my mother was in hospital recently with her bad chest we discussed it with her and dad and only he along with myself and my brothers should visit, she was just having some treatment and wasn't gonna pop her clogs by the looks of it so there was no need for the bedside vigil, compared to the others on the ward and we only visited her in the evening and dad stopped by in the morning to give her some papers and snacks and went on his way. She recovered relativly quick I would say and felt alot better for it just talking to the other patients during the day and watching TV and texting her friends.

It was us at home inundated with calls and texts at all hours from friends and relatives we barely see begging us to let them go and see her with their horde of germ-ridden kids. No thanks. Mum didn't need it, the staff didn't need it and the patients in her bay who were much sicker than mum did not need it.

Well, our manager has extended visiting times to 8am-10pm. We have a CONSTANT stream of people moaning, complaining, demanding. ALL DAY LONG.

They sit there, from 8am, doing nothing but getting in the way. They don't help or encourage their mum/dad to eat. They don't do anything productive but sit on the bed, stopping their relative from resting with inane chatter.

I hate them too. I have no problem with the reasonable ones who are happy to do little things to help. But man, are the crazy ones crazy.

It is all true that families and patients behave this way because of their social conditioning about Nurses and because of unrealistic views they have as a result of media portrayals of Nurses, Doctors, and Hospitals.

I felt really sad when I read this piece from dis-illusioned nurse, because i can relate to it so very much.

I began nursing 21 years ago, at the age of 16, in a little care home owned and run by an old-fashioned Matron, she was amazing and she taught me the absolute very best of basic nursing care, she inspired me massively, and taught me the real fundamentals.

A few years later I got a job in care home that was diabolical, where patients were neglected and totally uncared for. I formally reported them and decided to do my training, so that I would have the authority to challenge and change such bad standards in the future.

Nursing, and GOOD BASIC NURSING CARE is my roots, and I care massively.

After 10 years of being qualified I almost hate nursing, totally relating to the nurse in your article.

Nursing in todays NHS is like trying to fit a square peg into a round hole, blindfolded, with your hands tied behind your back and a gun to your head. Which i could handle, but its having relatives eyes staring at you, thinking "can't you do any better you uncaring bitch?"

It is a mission that is impossible with too many patients to care for, with too few pairs of hands, especially qualified pairs of hands.

I hate the way I get stared at by the public/relatives, I know what they're thinking (as I'm convinced now/paranoid maybe that every relative is a Daily Fail reader...)

They're thinking that I don't care, that the basics are beneath me, that i'm too poss to wash etc. They haven't got a clue - and more fool them because very soon this DAMNED GOOD NURSE WITH EXCELENT BASIC NURSING SKILLS will be getting the fuck out of here and retraining to be a teacher or something.

Your dirty look and shitty comments, your rolling eyes and huffing and puffing will be the end of nursing for me. And believe me, that will be your relatives loss as much as it will be mine.

All very sad. At least in the ICU we are a bit more protected in this respect-most relatives get the gist that ALL the patients on ventilators are pretty sick. We have a reception area with free tea and coffee where they can wait and most are pretty understanding about physio, doctors rounds etc...however, as I also deal with the admissions unit and ED I have also seen the absolute worst in terms of behaviour. Sometimes being in scrubs helps- visitors don't always realise that I am a nurse (despite my name badge indicating so). If they start saying that they will complain I politely spell out my name for them and my job title (senior sister). Mostly they do not bother- its just sounding off. I carry a little pocketbook and record whats happened-just in case. I advise all the clinical staff I come into contact with to do the same. Also to use the communications sheet in the nursing notes/medical notes and the alert functions on our e-notes. I have also called the Plod to ED in the past to arrest abusive relatives who have hit staff members.I have friends who deal with the public in other jobs and believe me, its not just NHS staff who are treated like crap. Joe Publics at large are a bunch of ungrateful, demanding prats who want someone else to run their lives for them.

Have you guys ever noticed that it tends to be daughters rather than sons that freak out?

A son will come to the nurses station and ask you why mum isn't getting the digoxin that her GP prescribed anymore. I explain that her dig levels were high (common in older people because their organs cannot process drugs very well) which is why she got poorly and came into the hospital. Therefore the doctors decided to withold her digoxin. Which is of course the safest road to go down when a patient is dig toxic. Son accepts this.

A daughter on the other hand will interrupt a Nurse on her 54th attempt to hang blood on a bleeder to scream and hollar because mum doesn't have her slippers on and they are *gasp* missing.

And whilst behaving like she is auditioning for the film Terms of Endearment she demands to know what happened to said slippers and demands that someone look for them.

Then she starts giving lectures about treating patients as people. Um. What about the man you just stopped from getting his blood in order to bitch about £2 slippers from Boyes you fucking nutter! Is he not a person too?

Does one honestly believe that barefeet are the worst thing that his happening on this ward at the moment? And no your mum wont slip and fall because she cannot walk. For fucks sake cover her feet with a blanket until I can abandon my patients to search the hospital for slippers.

God forbid if the daughter is the one asking about why the digoxin is not being given. You can explain to her 150 times about digoxin toxicity and why the dig needs to be witheld. She will still be ringing the daily mail to tell them that mum wasn't given her medication because all the staff hate old people.

When I first started the frightened and stressed relatives had all of my patience and understanding. After a year of being a Nurse they had sucked every last bit of empathy and humanity out of me and left nothing but a former human being who has the eyes of a beaten dog.

Have you guys ever noticed that it tends to be daughters rather than sons that freak out?

A son will come to the nurses station and ask you why mum isn't getting the digoxin that her GP prescribed anymore. I explain that her dig levels were high (common in older people because their organs cannot process drugs very well) which is why she got poorly and came into the hospital. Therefore the doctors decided to withold her digoxin. Which is of course the safest road to go down when a patient is dig toxic. Son accepts this.

A daughter on the other hand will interrupt a Nurse on her 54th attempt to hang blood on a bleeder to scream and hollar because mum doesn't have her slippers on and they are *gasp* missing.

And whilst behaving like she is auditioning for the film Terms of Endearment she demands to know what happened to said slippers and demands that someone look for them.

Then she starts giving lectures about treating patients as people. Um. What about the man you just stopped from getting his blood in order to bitch about £2 slippers from Boyes you fucking nutter! Is he not a person too?

Does one honestly believe that barefeet are the worst thing that his happening on this ward at the moment? And no your mum wont slip and fall because she cannot walk. For fucks sake cover her feet with a blanket until I can abandon my patients to search the hospital for slippers.

God forbid if the daughter is the one asking about why the digoxin is not being given. You can explain to her 150 times about digoxin toxicity and why the dig needs to be witheld. She will still be ringing the daily mail to tell them that mum wasn't given her medication because all the staff hate old people.

When I first started the frightened and stressed relatives had all of my patience and understanding. After a year of being a Nurse they had sucked every last bit of empathy and humanity out of me and left nothing but a former human being who has the eyes of a beaten dog.

"I have friends who deal with the public in other jobs and believe me, its not just NHS staff who are treated like crap. Joe Publics at large are a bunch of ungrateful, demanding prats who want someone else to run their lives for them."

Yes rude and demanding people are everywhere. But Debenham's/Homebase/Asda staff doesn't having to worry about being held responsible for someone's death because they missed something whilst dealing with rude and demanding people.

Dear Anne, I am sorry some of my consultant colleagues have been moaning. I can only say that nurses (RN and HCA) on my ward are brilliant. I have written to management detailing their workload is too excessive (wrote detailed 8 page document!) but was ignored. Complaining too loudly can get you sent to occupational health for 'stress' so have to be careful

I still think that we should have a charge nurse or a patient liason nurse on the ward to give families information.

But we do not have that. We do not have anyone who can stop to talk and answer the same inane questions over and over again without compromising patient care.

When I stop to answer questions patient care is stopped. Patients cannot have their care stopped for 20 minutes out of every hour.

I sometimes wonder if these relatives think that there is another Nurse who can continue giving and chasing down drugs whilst I answer questions?

There needs to be rules enforced by the hospital. Perhaps a pamphlet?

1.One family member rings once a day. THAT IS IT.

2.If the Nurse cannot stop to talk to you it isn't because she is hiding something you paranoid freak. Patient care comes before family questions.

3.It is impossible for the Nurse to know when the drugs are coming, when the ambulance is coming, when the test is going to be and when the doctor is coming. The Nurses do not have GPS on these people. Hell, they probably don't even know themselves when they are going to arrive. Therefore pulling the Nurse away from patient care to ask those questions over and over again is now a felony with a 3 year minimum sentence.

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In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.

Why has Nursing Care Deteriorated

Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.

About Me

I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions.
I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS.
Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.

Quotes of Interest. Education of Nurses.

Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.

Registered Nurse Staffing Ratios

International Council of Nurses Fact Sheet:

In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.

A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)

Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.

Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications

•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)

Disclaimer

I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am. Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.